Medical school: NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Graduated: 1982
NPI: 1568423028
Practice Locations (2)
401 MAIN ST, SUITE 1
JOHNSON CITY, NY 137902064
401 MAIN ST, SUITE 1
JOHNSON CITY, NY 137902065
6077549870141
Source: CMS National Downloadable File, September 2026.